Common Questions

Counseling/therapy is a collaborative process based on the relationship between you (individual/couple/family) and your counselor/therapist. It involves an agreement about the goals and tasks for treatment. It is grounded in dialogue and provides an emotionally safe and supportive environment to allow you to explore, discover, acknowledge and talk openly with a professional who is trained to listen, is multipartial, and who will help you identify and change issues that are keeping you from feeling your best and achieving your goals.

Counselors/therapists will help you develop healthier, more effective ways of dealing with issues through the use of empirical procedures and a wealth of knowledge about how individuals, families and systems function.

When should you consider counseling/therapy?

We all experience pain throughout our lifetime. Some people experience more challenges than others. You may have learned to navigate your hardships on your own quiet well. But… Would you consider not working alone? Having support, another perspective and the desire to open up to explore how to do things differently may bring you a more rewarding outcome in trying to cope with an adversity. Counseling/therapy is for people, who have enough self-awareness to realize they need a helping hand. It is about your taking responsibility for dealing with what is happening with you.

Some people seek counseling/therapy because they have felt depressed, anxious or angry for a long time. Others may want help to better their relationships with their partners or other family members. Others may want help in dealing with traumatic stress and addiction or a chronic illness that is interfering with their emotional or physical well-being. Others may need assistance in coping with the stress of being a gender/sexual or ethnic minority. Still others may be going through a divorce, facing an empty nest, feeling overwhelmed by a new job or grieving their pet’s death.

What about medication vs. psychotherapy?

Overall, the effects of counseling/therapy are accepted to be significant and large. These effects of are generally constant across most diagnostic conditions; variations depend on severity, chronicity, complexity, social support, and intensity; clinician and client characteristics, and context factors (Hubble, Duncan & Miller, 2010).

According to the APA (2015), counseling/psychotherapy “is cost-effective, reduces disability, morbidity, and mortality, improves work functioning, decreases use of psychiatric hospitalization, and at times also leads to reduction in the unnecessary use of medical and surgical services including for those with serious mental illness (Dixon-Gordon, Turner, & Chapman, 2011; Lazar & Gabbard, 1997).” It has been established that there are key links between mental and physical health and the field has been moving towards integrating them within the primary health care system. It is well established that the use of pharmacological treatment alone does not solve relational, social, emotional and behavioral issues in the long-term. Instead of focusing solely on the amelioration of symptoms, counseling/therapy addresses the core of your distress and the behavior patterns that maintain it. When appropriate, pharmacological treatment should be considered, and an integrative approach to wellness is probably your best option. Consult with your medical doctor or psychiatrist to determine what’s best for you.

What kind of credentials do counselors/therapists have and what do they mean?

There are a variety of professionals in the mental health field. Some have master’s level degrees (typically 2/3 years of training including a part-time internship) and some have a doctoral degree or Ph.D. (typically 5 or more years of training including a full time internship). The initials that professionals use after their names indicate what kind of license they have. Licensure is given when the individual has the correct educational background, supervised work experience, has passed an exam for licensure, and has knowledge of pertinent state law.

The following list includes the titles given to master’s level licensed professionals:

LCSW, Licensed Clinical Social Worker

LISW, Licensed Independent Social Worker

LPC, Licensed Professional Counselor

LMFT, Licensed Marriage and Family Therapist

CAC (I, II, or III), Certified Addictions Counselor – This is a certification that a professional may obtain in conjunction or after attaining their master’s degree.

The following list includes the titles given to doctoral level licensed professionals:

Ph.D., Doctor of Philosophy, a psychologist – Licensed Psychologist

Psy.D., Doctor of Psychology – Licensed Psychologist

What about confidentiality? Does what we talk about in counseling/therapy remain confidential?

Confidentiality is one of the cornerstones of counseling/therapy and it is a part of every mental health provider’s code of ethics. You need a safe space to discuss your issues without fear that information will leave the room. Your privacy is a very serious matter and there are laws in place to protect it. In fact, the Health Insurance Portability and Accountability Act (HIPAA) contains a privacy rule that creates national standards to protect individuals’ medical records and personal health information, including information about counseling/therapy and mental health.

While a mental health provider cannot share information about you without your consent, there are exceptions relative to:

Protecting the client or the public from serious harm, for example, when a client discusses plans to attempt suicide or harm another person.

Ongoing domestic violence, abuse or neglect of children, the elderly or people with disabilities.

Responding to a court order when a person’s mental health is in question during legal proceedings.

Glossary

Anorgasmia

The inability to reach orgasm during sexual intercourse; it has been mostly documented for women than men, but there are similarities in both sexes in terms of the possible causes and therapeutic outcomes. It is estimated that around 90 percent of anorgasmia problems are related to psychological issues. There are different types of anorgasmia:

• Primary anorgasmia: when you have never experienced an orgasm.

• Secondary anorgasmia: when you used to have orgasms, but are now experiencing difficulty reaching climax.

• Situational anorgasmia: when are able to orgasm only under some circumstances (e.g., during oral sex or masturbation)

• General anorgasmia: when you cannot orgasm in any situation or with any partner.

Female Orgasmic Disorder (DSM V)

“Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The diagnosis of Female Orgasmic Disorder should be based on the clinician’s judgment that the woman’s orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives. The disturbance causes marked distress or interpersonal difficulty.”

Male Orgasmic Disorder - Delayed Ejaculation - (DSM V)

“Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person’s age, judges to be adequate in focus, intensity, and duration. The disturbance causes marked distress or interpersonal difficulty.”

Female Sexual Arousal Disorder (DSM V)

“Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement. The disturbance causes marked distress or interpersonal difficulty.”

Dr. Hernandez-Wolfe is a systemically-trained Counseling Psychologist and Licensed Marriage and Family Therapist (Oregon, New Jersey, Maryland) and Licensed Professional Counselor (Maryland), with over 20 years of clinical experience.